During surgery for the repair of congenital heart defects, especially the repair of a ventricular septal defect (VSD), Tetralogy of Fallot, and acquired heart defects, there is a need for good illumination inside the heart to facilitate accurate repair of the defects. Cardiac surgeons usually use headlights for this purpose. However, since these defects are situated deeply inside the heart and light cannot bend, headlights usually do not provide satisfactory illumination of the defect. The success of surgery for these heart defects depends on accurate and rapid repair, and good illumination is an important factor in ensuring successful surgery. Thus, there it would be highly desirable to provide an intracardiac device that will readily provide illumination of these types of defects.
The intracardiac procedures discussed above are examples of surgical procedures performed within body cavities and/or within organs. Any operation performed at such a site creates similar problems. First, of course, is the above-noted problem of there often being no direct illumination path to the surgical site. Headlights or light stands must be continually adjusted and manipulated to illuminate the field. Additionally, these sites constantly fill with blood and other body fluids, requiring frequent aspiration or else the site, even if properly illuminated, will be obscured. These considerations become acute in tight fields, an extreme example of which is within the chambers of the heart. It is difficult to insert and manipulate retractors, aspiration tips, surgical instruments and light probes all within the space available during open-heart surgery. Thus, it would be further desirable to provide a device that provided aspiration at an illuminated site while occupying a minimum amount of space.
Prior attempts to combine the illumination and aspiration functions have met with limited success. A rigid brain retractor that includes an illuminator and suction conduit is disclosed in U.S. Pat. No. 3,626,471--Florin. In the disclosed device, two tubular aspiration conduits are attached to the retractor and carry aspirated fluid away from the brain and a separate fiber optic probe is disposed alongside the exterior of the aspiration conduits and is also attached to the retractor. Aspirated fluid is drawn into a distal cross-sectional opening in each of the conduits.
Another device combining aspiration, irrigation and illumination into a coaxial probe is disclosed in U.S. Pat. No. 4,617,013--Betz. The irrigation tube is surrounded by the aspiration tube which, in turn, is surrounded by light emitting material. Thus, the area surrounding the specific aspiration or irrigation site is illuminated, but the central portion where the actual probe is disposed is not directly illuminated. The probe itself is of a relatively large cross-sectional area and is not flexible. The coaxial probe is brought into the area of interest manually by a surgeon or nurse holding the device. Aspiration fluid is drawn into the cross-sectional opening across the distal end of the device, in the same manner that irrigation fluid is introduced. The fiber optic portion of the coaxial probe is simply terminated at the same point as the aspiration and irrigation conduits.
Thus, the prior art has been unable to provide a device that permits clear and precise illumination of an interior surgical site while also aspirating blood and body fluids that had collected at the site. As noted above, it would be desirable that such a device occupy a minimum amount of space so as to not interfere with surgical procedures performed in tight fields, such as in intracardiac surgery. It is therefore a specific object of the present invention to provide illumination inside the heart during surgery for repair of intracardiac defects and, at the same time, clear the field of blood and fluids by aspirating the heart chamber in which it is placed.